Conference Presentations by Piotr Rzepecki
Papers by Piotr Rzepecki
Fragility scales are intended to help in therapeutic decisions. Here we asked if the fragility as... more Fragility scales are intended to help in therapeutic decisions. Here we asked if the fragility as-sessment in MM patients ≥75 years old qualified for treatment by the local physician correlates with the choice of treatment: a 2- or 3-drug regimen. Between 7/2018 to 12/2019 we prospectively enrolled 197 MM patients at the start of treatment from the 13 Polish Myeloma Group centers. The data to assess fragility were prospectively collected, but centrally assessed fragility was not disclosed to the local center. The activity of daily living (ADL) could be assessed in 192 (97.5%) and was independent in 158 (80.2%), moderately impaired in 23 (11.7%), and 11 (5.6%) in com-pletely dependent. Patients with more than 3 comorbidities were 26.9% (53 patients). Thus, ac-cording to the Palumbo calculator, 43 patients were in the intermediate-fitness group (21.8%), and the rest belonged to the frailty group (153, 77.7%). Overall, 79.7% of patients (157) received 3-drug regimens and 20.3% (40) rec...
Acta Haematologica Polonica
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
Cells
Identification of patients with activation of the immune system which indicates the presence of i... more Identification of patients with activation of the immune system which indicates the presence of infection is essential, especially in the times of the global coronavirus 2019 (COVID-19) pandemic. The aim of the present study was to evaluate the reactive lymphocytes (RE-LYMP) parameter in COVID-19 and to correlate it with activation lymphocytes markers by flow cytometry. The study group consisted of 40 patients: with COVID-19 infection (n = 20) and with others virus infections without COVID-19 (COVID-19(−) virus (n = 20)) and 20 healthy donors (HC). Blood count and flow cytometry were performed. The COVID-19(+) group had significantly lower RE-LYMP parameter than the COVID-19(−) virus group (5.45 vs. 11.05, p < 0.05). We observed higher proportion of plasmablasts in the COVID-19(+) and COVID-19(−) virus groups than HC (8.8 vs. 11.1 vs. 2.7, p < 0.05). In the COVID-19(+) there was a lower proportion of CD4+ CD38+ cells than in the other groups (significant differences between CO...
Diagnostics, Mar 28, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Acta Haematologica Polonica, 2021
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
Cancers, 2021
Lung cancer remains one of the most aggressive solid tumors with an overall poor prognosis. Molec... more Lung cancer remains one of the most aggressive solid tumors with an overall poor prognosis. Molecular studies carried out on lung tumors during treatment have shown the phenomenon of clonal evolution, thereby promoting the occurrence of a temporal heterogeneity of the tumor. Therefore, the biology of lung cancer is interesting. Cancer stem cells (CSCs) are involved in tumor initiation and metastasis. Aging is still the most important risk factor for lung cancer development. Spontaneously occurring mutations accumulate in normal stem cells or/and progenitor cells by human life resulting in the formation of CSCs. Deepening knowledge of these complex processes and improving early recognition and markers of predictive value are of utmost importance. In this paper, we discuss the CSC hypothesis with an emphasis on age-related changes that initiate carcinogenesis. We analyze the current literature in the field, describe our own experience in CSC investigation and discuss the technical cha...
Cells, 2021
Studying the dynamics changes of neutrophils during innate immune response in coronavirus 2019 (C... more Studying the dynamics changes of neutrophils during innate immune response in coronavirus 2019 (COVID-19) can help understand the pathogenesis of this disease. The aim of the study was to assess the usefulness of new neutrophil activation parameters: Immature Granulocyte (IG), Neutrophil Reactivity Intensity (NEUT-RI), Neutrophil Granularity Intensity (NEUT-GI), and data relating to granularity, activity, and neutrophil volume (NE-WX, NE-WY, NE-WZ) available in hematology analyzers to distinguish convalescent patients from patients with active SARS-CoV-2 infection and healthy controls (HC). The study group consisted of 79 patients with a confirmed positive RT-PCR test for SARS-CoV2 infection, 71 convalescent patients, and 20 HC. We observed leukopenia with neutrophilia in patients with active infection compared to convalescents and HC. The IG median absolute count was higher in convalescent patients than in COVID-19 and HC (respectively, 0.08 vs. 0.03 vs. 0.02, p < 0.0001). The v...
Cancers, 2020
from the NSCLC milieu support a role of monocyte-line cells in cancer immunity. a high proportion... more from the NSCLC milieu support a role of monocyte-line cells in cancer immunity. a high proportion of monocytes with low expression of CD62L indicates the participation of monocytes in attenuation of anticancer response.
Acta Haematologica Polonica, 2020
Cells, 2020
Cell response to novel coronavirus disease 19 (COVID-19) is currently a widely researched topic. ... more Cell response to novel coronavirus disease 19 (COVID-19) is currently a widely researched topic. The assessment of leukocytes population and the maturation of both B and T lymphocytes may be important in characterizing the immunological profile of COVID-19 patients. The aim of the present study was to evaluate maturation of B and T cells in COVID-19 patients with interstitial lesions on chest X-ray (COVID-19 X-ray (+)), without changes on X-ray (COVID-19 X-ray (−)) and in healthy control. The study group consisted of 23 patients divided on two groups: COVID-19 X-ray (+) n = 14 and COVID-19 X-ray (−) n = 9 and control n = 20. The flow cytometry method was performed. We observed a significantly higher percentage of plasmablasts and lower CD4+ lymphocytes in COVID-19 X-ray (+) patients than in COVID-19 X-ray (−) and control. In the COVID-19 X-ray (+) patients, there was a lower proportion of effector CD4+ T cells, naïve CD8+ T cells and higher central memory CD4+ cells and effector CD8...
Clinical Medicine. Therapeutics, 2009
Oral mucositis (OM) is one of the most debilitating and common side effects of intensive anti-can... more Oral mucositis (OM) is one of the most debilitating and common side effects of intensive anti-cancer treatment. OM is associated with adverse clinical and economic outcomes. In addition to its symptomatic impact, OM increases the likelihood of unplanned breaks or delays in anti-cancer treatment, reduction in dose of chemotherapy, use of feeding tube placement or total parenteral nutrition, the need for an intravenous line, opioid use and hospitalization. Palifermin is a N-truncated recombinant human keratinocyte growth factor (KGF), a member of the fibroblast growth factor (FGF) family, which binds specifically to the human KGF receptor and induces proliferation and differentiation of epithelial cells, including gastrointestinal epithelial cells, hepatocytes, type II pneumocytes, and transitional urothelial cells. It is the first agent approved by the U.S Food and Drug Administration and other regulatory authorities around the world for use in the prevention of oral mucositis caused...
Annals of Hematology, 2019
Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fun... more Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter crosssectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p < 0.0001). Infections with Gram-negative bacteria were more frequent than Gram-positives in adults (64.6% vs Krzysztof Czyżewski and Jan Styczyński contributed equally to this work.
Bone marrow transplantation, Jan 25, 2018
Transplant-associated thrombotic microangiopathy (TA-TMA) is a life-threatening complication of a... more Transplant-associated thrombotic microangiopathy (TA-TMA) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation (HSCT). This study evaluated clinical and morphological practices of TA-TMA diagnosis in EBMT centers. Two questionnaires, one for transplant physician and one for morphologist, and also a set of electronic blood slides from 10 patients with TA-TMA and 10 control patients with various erythrocyte abnormalities, were implemented for evaluation. Seventeen EBMT centers participated in the study. Regarding criteria used for TA-TMA diagnosis, centers reported as follows: 41% of centers used the International Working Group (IWG) criteria, 41% used "overall TA-TMA" criteria and 18% used physician's decision. The threshold of schistocytes to establish TA-TMA diagnosis in the participating centers was significantly associated with morphological results of test cases evaluations (p = 0.002). The mean number of schistocytes reported fr...
Future oncology (London, England), 2015
Tyrosine kinase inhibitors are novel therapies targeting specific cellular signalling pathways. S... more Tyrosine kinase inhibitors are novel therapies targeting specific cellular signalling pathways. Sunitinib and sorafenib primarily block tyrosine kinase receptors involved in the progression of many tumours, including clear cell renal cell cancer (ccRCC). Although developed to target selected receptors, it is becoming apparent that they inhibit other kinases; this may result in the development of unexpected side effects. This is potentially dangerous as kinases on noncancerous cells are also inhibited. TKI off-target effects contributing to cardiotoxicity, hypothyroidism, hypertension, fatigue, hair depigmentation, hand-foot syndrome and gastrointestinal perforation have been described. We report three patients (3/412) treated with sunitinib and sorafenib who developed chronic myeloid leukaemia (CML) during treatment for ccRCC, proposing a molecular mechanism of tyrosine kinase inhibitors action on bone marrow cells that might be co-responsible for CML development.
Współczesna Onkologia, 2012
Malignant tumours of the kidneys are relatively rare tumours that occur in adults, although there... more Malignant tumours of the kidneys are relatively rare tumours that occur in adults, although there has been a constant increase in the incidence of this cancer type in recent years. It occupies the 10 th place in terms of the number of new cases of cancer in men and 14 th place in women. Considerable progress in the treatment of renal cell carcinoma over the last years has forced researchers to look for new factors of potential prognostic or predictive value in this tumour type in order to clarify the selection of patients for optimal treatment. The drugs from the group of tyrosine kinase inhibitors have played a decisive role. So far, the Motzer model, grouping the prognostic factors, has been most commonly used in clinical practice. Based on the current research looking for new markers of prognostic or predictive value, these factors can be divided into cellular hypoxia-induced proteins and proteins regulating the cell cycle and the apoptosis process. In the second part of this study, hypoxia-inducible factors will be discussed. K Ke ey y w wo or rd ds s: : kidney cancer, cellular hypoxia-inducible factors, prognostic factors, predictors.
Bone Marrow Transplantation, 2007
In this multicenter study, we assessed the use of palifermin (recombinant human-keratinocyte grow... more In this multicenter study, we assessed the use of palifermin (recombinant human-keratinocyte growth factor 1) in the prevention of oral mucositis (OM) and acute GvHD (aGvHD) induced by a hematopoietic stem cell transplant (HSCT). Fifty-three patients with hematological diseases received three doses of palifermin (60 lg/kg once daily i.v.) pre-and post-conditioning regimens (total six doses). A retrospective control group of 53 transplant patients received no palifermin. There was a significant reduction in the incidence of OM of WHO (World Health Organization) grades 1-4 (58 vs 94%, Po0.001), 3-4 (13 vs 43%, Po0.001) and the median duration of OM (4 vs 9 days, Po0.001) in the palifermin group compared to the control group. The incidence of analgesics (32 vs 75.5%, Po0.001), opioid analgesics (24 vs 64%, Po0.001) and total parenteral nutrition (11 vs 45%, Po0.001) was also significantly reduced. The analysis of distribution of affected organs revealed that aGvHD was less prevalent in the palifermin group (P ¼ 0.036). There was no significant difference in the onset of any OM after HSCT, time to engraftment and length of hospitalization between groups. The drug was generally well tolerated and safe. Our results suggest that the use of palifermin reduces OM and probably aGvHD after HSCT, but a randomized trial is needed.
Biology of Blood and Marrow Transplantation, 2007
Background: No studies describe individual physician practices in hematopoietic stem cell transpl... more Background: No studies describe individual physician practices in hematopoietic stem cell transplantation (HCT). We conducted an international Internet-based survey of physicians to explore the spectrum of supportive care practices in HCT. Methods: Questions addressed pre-HCT patient and donor testing, infectious disease prophylaxis and treatment, and protective isolation recommendations after HCT. Response options were closed-ended offering several management approaches. The response rate was 526/627 (84%) of eligible physicians who confirmed receipt of the invitation, or 526/1823 (29%) of all invitations. Respondents were clinically active with a median of 2.5 days in clinic and 4 months inpatient service (60% clinical effort). 57% practiced in the U.S. Results: Measurement of cardiac and pulmonary function and requirement for signed informed consent before HCT was almost universal (Ͼ90%). Though use of antifungal prophylaxis was routine (90-96%), other measures such as myeloid growth factors (45-79%), antibacterial prophylaxis (50-79%) and ursodeoxycholic acid (22-41%) were less common. Approximately half used a single agent broad spectrum antibiotic for empiric treatment of febrile neutropenia, while a third used combination therapy that included an aminoglycoside. While 94-97% recommended handwashing and 73-86% used hepa-filtration, Ͻ 50% used other isolation procedures during hospitalization (e.g., masks, gloves, gowns). Recommendations for protective isolation after HCT, such as visitors in the home, use of masks and/or gloves in public, eating out, going to indoor public places (median Ͻ 100 days) and return to work/school (median 3-6 months) were variable, but stricter policies were predicted by allogeneic/myeloablative and pediatric versus adult practice. Other physician characteristics, such as US vs. non-US and shorter time since completion of fellowship also predicted stricter isolation recommendations and appear less biologically justifiable. Conclusions: Our results demonstrate the heterogeneity of supportive care practices in HCT. For most practices, little data exist to favor one approach over another. Where data do exist, as for antifungal prophylaxis and ursodeoxycholic acid during myeloablative procedures, uptake into standard practice is variable. Although the relative contribution of supportive care management to overall success of HCT is unknown, the diversity of supportive care approaches suggests randomized studies are possible.
Annals of Hematology, 2010
Recent developments in the field of targeted therapy have led to the discovery of a new drug, ple... more Recent developments in the field of targeted therapy have led to the discovery of a new drug, plerixafor, that is a specific inhibitor of the CXCR4 receptor. Plerixafor acts in concert with granulocyte colony-stimulating factor (G-CSF) to increase the number of stem cells circulating in the peripheral blood (PB). Therefore, it has been applied in the field of hematopoietic stem cell mobilization. We analyzed retrospectively data regarding stem cell mobilization with plerixafor in a cohort of 61 patients suffering from multiple myeloma (N=23), non-Hodgkin's lymphoma (N=20), or Hodgkin's lymphoma (N=18). At least one previous mobilization attempt had failed in 83.6% of these patients, whereas 16.4% were predicted to be poor mobilizers. The median number of CD34+ cells in the PB after the first administration of plerixafor was 22/μL (range of 0-121). In total, 85.2% of the patients proceeded to cell collection and a median of two (range of 0-4) aphereses were performed. A minimum of 2.0 x 10 6 CD34+ cells/kg b.w. was collected from 65.6% of patients, and the median number of cells collected was 2.67 x 10 6 CD34+ cells/kg b.w. (0-8.0). Of the patients, 55.7% had already undergone autologous stem cell transplantation (autoSCT) and the median time to neutrophil and platelet reconstitution was 12 and 14 days, respectively. Cases of late graft failure were not observed. We identified the diagnosis of non-Hodgkin's lymphoma and previous radiotherapy as independent factors that contributed to failure of mobilization. The current report demonstrates the satisfactory efficacy of plerixafor plus G-CSF for stem cell mobilization in heavily pre-treated poor or predicted poor mobilizers.
Acta Haematologica Polonica, 2017
Infections are the most serious complications in patients undergoing hematopoietic cell transplan... more Infections are the most serious complications in patients undergoing hematopoietic cell transplantation (HCT). Vaccinations occur to be undeniably one of the most important prophylactic strategies and are routinely recommended in the post-transplantation period. Their use reduces the incidence of infections and infection-related mortality. In this paper, we present the current guidelines for active immunization after HCT for the Polish patient population as worked out by the Polish Adult Leukemia Group (PALG). The guidelines include the recommended vaccines, the optional vaccines and vaccination with live pathogens. The management in specific situations such as graft versus host disease and for HCT recipients travelling to exotic countries is clarified. We also present the proposal for organization of the vaccination program in transplant centers. The
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Conference Presentations by Piotr Rzepecki
Papers by Piotr Rzepecki